IntroductionIn the wake of the unprecedented public health challenge of the COVID-19 pandemic, it is highly significant to recognise the mental health impact of this mounting threat on healthcare providers (HCPs) working in the obstetrics and gynaecology department. Experience from epidemics and emerging literature around COVID-19 show that the unparalleled amount of stress that HCPs are dealing with is linked with the increased burden of mental health conditions. We aim to conduct an exploratory qualitative descriptive study to assess HCPs’ perceptions of mental health amid the COVID-19 pandemic in the obstetrics and gynaecology department of a public sector tertiary care hospital of Karachi, Pakistan.Methods and analysisThis study will use a qualitative descriptive approach where approximately 20–25 HCPs from the obstetrics and gynaecology department will be recruited using a purposive sampling approach. Data will be collected through semistructured interviews and it will be analysed thematically using NVivo V.12 Plus software.Ethics and disseminationEthical approval for this study has been obtained from the Institutional Review Board Committee of Jinnah Postgraduate Medical Center hospital. The study results will be disseminated to the scientific community and the HCPs participating in the study. The findings will help us to explore the doctor’s perceptions of mental health during the current pandemic of COVID-19 and its impact on their daily lives and mental well-being.

Introduction: The capability to diagnose pathologically morbid adherent placenta has transformed over the preceding era. Depending on the knowledge and availability of equipment, ultrasound (ultrasound), MRI or a combination of these methods are currently used. Ultrasound is popular for its low cost and availability, and is broadly used to detect location of placental and possible anomalous growth. Place and Duration: In the Gynecology Department of Civil Hospital Quetta for six-months duration from March 2021 to September 2021 Methods: 72 total pregnant women booked on the third trimester of pregnancy (diagnosed with early ultrasound) with diagnosis of the placenta previa were selected. Women in the primigravid group and females with pregnancies complicated by heart disease, diabetes and hypertension were omitted from the analysis. Color Doppler ultrasound was performed in all patients and the absence or presence of morbidly adherent placenta previa was detected. The results of the color Doppler ultrasound examination were correlated with the results of the surgical treatment (concluding it as the gold standard). Results: 28.21 ± 2.70 years was the mean age of the patients. Ultrasound revealed MAP in 9 (12.5%) females. The ultrasound positive patients had 08 true positives and 01 false positives. Of the 63 ultrasound negative patients, 61 were true negative (P≤0.05) and false negative patients were two patients. The calculated specificity, sensitivity, negative and positive predictive value and analytical accurateness of the color Doppler test in the prenatal MAP diagnosis were rated at 97.21%,86.8%, 97.89%, 86.8%% and 98.95%, respectively. Conclusions: In this study, it was found that the diagnostic accurateness of color Doppler ultrasound is higher in the prenatal analysis of morbidly adherent placenta in pregnant women with placenta previa. Keywords: Sensitivity, non-invasive imaging modality and Placenta accreta

Background: Earlier analysis shows that metformin is beneficial clinically in treating polycystic ovary syndrome (PCOS) by reducing hyperinsulinemia. Aim: The goal of this study was to determine the importance of metformin in modifying amenorrhea/ oligomenorrhea and anovulation within six months in women with polycystic ovary syndrome and hyperinsulinemia. Another goal was to evaluate hyperinsulinemia and weight loss with metformin in the studied people. Methods: This randomized controlled trial was held at the Obstetrics and Gynecology department of the Jinnah Postgraduate Medical Centre Karachi for one-year duration from July 2020 to July 2021. The study included 160 women who met the biochemical and clinical conditions for hyperinsulinemia and PCOS. Two females stopped taking the drug due to abdominal cramps, diarrhoea and nausea. Other excluding factors were inadequate adherence in one female women and use of other medications in two women. One female had anomalous levels of serum creatinine and was omitted from the analysis. So, 154 total patients were studied. 500 mg / day metformin orally was started and was held at 500 mg for six-months. FSH, serum LH, fasting insulin, fasting glucose and creatinine were measured in addition to ultrasound and body weight. After 6 months: fasting insulin levels, menstrual cycles, body weight and serum progesterone on day 21 were measured. Serum androgen levels remains high in PCOS along with Prolactin levels and the LH/FSH ratio may be greater than 2 times. So, these parameters were assessed after six months of metformin to determine the improvement in symptoms of oligomenorrhea and amenorrhea in PCOS and clinically with improvement in menstrual cycle. Results: Subsequently 6 months of treatment with metformin, 135 out of 154 (84%) women had regular periods, 24 of which were in the ovulation range of luteal progesterone (> 30 nmol / L). The average fasting insulin concentration among patients on metformin therapy reduced from 22.5 micro-U / ml to 21.01 micro-U / ml (p = 0.00). Keywords: PCOS, Metformin, irregular periods